Effect of percutaneous and open tenotomy on continuity of tendoachillis in relapsed clubfoot

Background: Tenotomy of tendon Achilles is one of the major components of Ponseti method and necessary to complete correction in about 80 to 90 % of patients, it is safely procedure can be done in outpatient office as percutaneous technique under local anesthesia or in operative room under general anesthesia as mini-open technique. This study was designed to evaluate effect of tendoachillis tenotomy either percutaneous or open on continuity of tendoachillis by open evaluation in relapsed club foot. Patient & method: This study was conducted on 18 individuals. They were divided into 2 equal groups: Group I: containing 9 patients both sex had previously percutaneous tenotomy is done and Group II: 9 patients both sex had previously open tenotomy is done. Results: percutaneous technique found easy dissection in 6 patients (66.7%) and difficult dissection in 3 patients (33.3%) and continuity found central and regular contour in 7 patients (77.8%) and fibrotic mass in 2 patients (22.2%), open technique found easy dissection in 5 patients (55.6%) and difficult dissection in 4 patients (44.4%) and continuity found central and regular contour in 5 patients (55.6%) and fibrotic mass in 4 patients (44.4%), Conclusion: the techniques tenotomy of tendoachillis had no effect on continuity of tendoachillis either open or closed techniques in management of club foot

Correlation of some predisposing intrinsic conditions with the morphological integrity of the Achilles tendon

Background: Most studies have focused on ill-tendons with a little insight on how intrinsic factors correlate with the Achilles tendon (AT) morphology. Aim: This study aims at establishing how blood pressure (BP), blood glucose (BG), and body mass index (BMI) correlate with the morphology of the AT with emphasis on width changes. Materials and Methods: Participants were volunteers who were recruited during and after an organized health fair by the Medical Students' body of All Saints University, School of Medicine, Commonwealth of Dominica. A total of 336 people, consisting of 135 males and 201 females volunteered for the study. The most dominant age group was between 60 and 65 years. A self-administered questionnaire was used to acquire necessary information, and a preliminary clinical procedure was used to check for BP, BG, and BMI. Ultrasound examination was done in B-mode using a linear array high-frequency probe with a mediolateral approach at the AT. Results: Among the participants, 42.68%, 69.75%, and 30.38% had normal BP, BG, and BMI readings, respectively. BP, BG, and BMI statistically supported the hypothesis.Individuals with extreme BP, BG, and BMI had their AT width wider when compared with individuals with normal systemic readings. Sonographic examination revealed most participants with normal tendon morphology while some identifiable changes were observed among others. Conclusion: This study suggests that BP, BG, and BMI could affect the morphological integrity of the AT. It indicates that asymptomatic high blood sugar and BP could weaken the AT, leading to pain which may appear unrelated to the physician and patient

Plaies du tendon calcanéen par rayons de roue arrière de moto

Objectifs - Déterminer les aspects épidémiologiques et le mécanisme lésionnel, et évaluer les résultats du traitement des plaies du tendon calcanéen engendrées par les rayons de roue arrière de moto. Matériel et Méthodes - Il s'agissait d'une étude rétrospective concernant tous les patients traités pour une plaie du tendon calcanéen occasionnée par les rayons de roue arrière de moto entre Janvier 2014 et Décembre 2016. Résultats - Durant la période d'étude, trente-quatre patients totalisant 34 lésions ont été recensés. Il y avait (n=20; 59%) hommes et (n=14; 41%) femmes. L'âge moyen était de 12 ans (4 et 37 ans). Les élèves étaient les plus concernés (n=18; 53%). La section du tendon était totale (n= 22;65%) et partielle dans (n=12 ; 35%). Les lésions associées prédominantes étaient les fractures du calcanéum (n=14). Les complications postopératoires étaient infectieuses (n=14 ; 41%). La cicatrice était disgracieuse (n=10 ;29%). Au recul moyen de 17 mois, le résultat fonctionnel évalué selon le score de Mc Comis était excellent (n=16; 47%), bon (n=10 ; 29%), moyen (n=5 ;15%), et mauvais (n= 3;9%). Conclusion - Les plaies du tendon calcanéen par rayons de roue arrière de moto sont fréquentes. Elles ont concerné les enfants d'âge scolaire. La réparation définitive par suture en urgence est possible pour les plaies vues tôt. Les suites opératoires immédiates peuvent être émaillées de complications infectieuses. Mais l'évolution à moyen terme est favorable

Is Z Division of The Achilles Tendon Always Necessary in Wide Exposure of The Back of The Distal Tibia and Ankle Joint? Report of a Preliminary Investigation

Background: In posterior approach to the back of tibia and ankle; mere retraction of the Achilles tendon can expose the operation site but when this exposure is not enough; Z division of the Achilles tendon is recommended in literature. The main objective of the study is to find out if Z division of the Achilles tendon is always necessary in posterior approach to the back of tibia and ankle for direct vision of the back of distal tibia; exploration of bones and joints of the posterior aspect of the ankle joint.Method: From 15/12/1997 to 30/12/2006 sixteen patients required surgical management of distal tibia fractures involving articular surfaces. Posterior approach with Achilles tendon division was indicated for satisfactory access to the back of tibia and ankle. In equal number of these patients division of the Achilles tendon was either by Z or longitudinal divisions. Intra and post operative assessment of both types of Achilles tendon division was done.Results: Longitudinal division of the Achilles tendon had advantages and should be preferred. Operation time; period of post- operative pain and cast immobilization were brief. There was full range of motion of the ankle joint after removal of cast.Conclusion: When division of the Achilles tendon is indicated for direct vision of the posterior aspect of the distal of tibia and ankle joint; Z division is not necessary. A good knowledge of anatomy and experience makes the procedure easier and quicker

Is Z Division of The Achilles Tendon Always Necessary in Wide Exposure of The Back of The Distal Tibia and Ankle Joint? Report of a Preliminary Investigation

Background: In posterior approach to the back of tibia and ankle; mere retraction of the Achilles tendon can expose the operation site but when this exposure is not enough; Z division of the Achilles tendon is recommended in literature. The main objective of the study is to find out if Z division of the Achilles tendon is always necessary in posterior approach to the back of tibia and ankle for direct vision of the back of distal tibia; exploration of bones and joints of the posterior aspect of the ankle joint.Method: From 15/12/1997 to 30/12/2006 sixteen patients required surgical management of distal tibia fractures involving articular surfaces. Posterior approach with Achilles tendon division was indicated for satisfactory access to the back of tibia and ankle. In equal number of these patients division of the Achilles tendon was either by Z or longitudinal divisions. Intra and post operative assessment of both types of Achilles tendon division was done.Results: Longitudinal division of the Achilles tendon had advantages and should be preferred. Operation time; period of post- operative pain and cast immobilization were brief. There was full range of motion of the ankle joint after removal of cast.Conclusion: When division of the Achilles tendon is indicated for direct vision of the posterior aspect of the distal of tibia and ankle joint; Z division is not necessary. A good knowledge of anatomy and experience makes the procedure easier and quicker

Operative Management of Congenital Talipes Equinovarus Deformity: Experience and Reason

Background: Congenital talipes equinovarus is the most common congenital anomaly of the foot and ankle. The prevalence of this condition in our environment is not known due to dearth of medical literature on the subject. The aim of this study was to determine the outcome of our operative management of resistant talipes equinovarus by elongation of tendo-Achilles and posteromedial soft tissue release. Methods: We present a retrospective review of congenital talipes equinovarus treated by Elongation of tendo Achilles (ETA) and Posterior Medial Release(PMR) at National Orthopaedic Hospital Enugu over a 6- year period (January1995- December 2000). Results: There were 63(68) males and 30(32) females with mean age of 2.06 years at presentation (range 1/12-18years). There was positive family history in 6(7) patients. More than half of the patients 63(68) came without any formal referral. The mode of delivery was spontaneous vaginal delivery in 81(87) and the first child appears to be more affected 22(24). The deformities on presentation varied from talipes equinovarus 50(54) to frank equinus in 3(3) and fifty-four (58) were bilateral. Sixty- three (68) had initial treatment ranging from serial casting in 46(50) to massage by traditional bonesetter in 2(2) and the average duration of this initial treatment was 20weeks (range 2-106weeks). The average age at surgery was 2.5years (range 3/12-24 years). All patients received postoperative cast for an average of 13 weeks. The commonest post- operative complication was medial wound breakdown. The average duration of follow-up was 30 weeks (range3weeks-3years). Some patients were lost to follow-up immediately the cast was removed. As at last visit 90were walking pain-free and do not require special shoe. The commonest residual deformity as at last visit was forefoot adduction in 17(18) patients. Conclusion: Elongation of tendo-Achilles and posteromedial soft tissue release are common operative procedures for CTEV. The short-term result of these procedures appears very good in our environment. However; the long-term result cannot be effectively analyzed due to high rate of loss to follow-up

The gross body weight; following the treatment of traumatically ruptured tendon by electrical stimulation

The purpose of this study was to investigate the effect which pulsed galvanic current stimulation of traumatically ruptured Achilles tendons has on their calf muscles; and on the gross body weight of each subject. The effect of current polarity (i.e. anodal and cathodal currents) on these variables were also studied. To achieve these the total body weights and the calf circumferences of the subjects prior to the traumatic rupture of their Achilles tendons and following treatment with the two currents (i.e. after the traumatic rupture of their tendons) were therefore compared to each other and to those measures in a group where healing took place without electrical stimulation